BSR 2026 Polymyalgia Rheumatica Guideline: Bone Protection, Faster Tapers, Early Methotrexate, IL-6R Blockade

The first BSR polymyalgia rheumatica update since 2009 gives pharmacists explicit targets for bisphosphonate coprescribing, glucocorticoid taper design, methotrexate co-management and IL-6R antagonist monitoring.

📅 Journal publication: Oct 1, 2026 · Last updated: Oct 14, 2026

BSR 2026 PMR guidelineBritish Society for Rheumatologypolymyalgia rheumaticaglucocorticoidsprednisolonemethotrexateIL-6R antagonistssarilumabtocilizumabbisphosphonatesglucocorticoid-induced osteoporosis Rheumatology / Immunology

Background Information

New PMR guideline supports safer glucocorticoid usage.

Glucocorticoids are effective for polymyalgia rheumatica but pose toxicity risks if used long-term. The updated guideline includes faster glucocorticoid tapering, methotrexate use, and bone protection strategies. This offers actionable strategies for minimizing glucocorticoid exposure and optimizing polymyalgia rheumatica treatment. Updated guidelines promote effective care and glucocorticoid-sparing options for polymyalgia rheumatica.

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Authors: Toyoda T, Bhide S, Boland C, Corp N, Engamba S, Felix L, Henderson E, Jones C, Lewis S, MacKeith P, Maddock J, Marshall K, O'Brien AV, Rees JD, Scrafton N, Subesinghe S, Twohig H, Wallace D, van der Windt DA, Mackie SL, Yates M, British Society for Rheumatology Guideline Steering Group

Citation: Toyoda T, Bhide S, Boland C, et al. The 2026 British Society for Rheumatology guideline for the treatment of polymyalgia rheumatica. Rheumatology (Oxford, England). 2026;65(10). doi:10.1093/rheumatology/keag502

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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